The American Academy of Neurology has issued important revisions to its guidelines for sports concussions in the Journal Neurology.

The academy has attempted to answer the following questions:

1. For athletes, what factors increase or decrease concussion risk?

2a. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those with concussion?

2b. For athletes suspected of having sustained concussion, what diagnostic tools are useful in identifying those at increased risk for severe or prolonged early impairments, neurologic catastrophe, or chronic neurobehavioralimpairment?

3. For athletes with concussion, what clinical factors are useful in identifying those at increased risk for severe or prolonged early post- concussion impairments, neurologic catastrophe, recurrent concussions, orchronic neurobehavioral impairment?

4. For athletes with concussion, what interventions enhance recovery, reduce the risk of recurrent concussion, or diminish long-term sequelae?

Here is the summary of their results:

“Specific risk factors can increase or decrease concussion risk. Diagnostic tools to help identify individuals with concussion include graded symptom checklists, the Standardized Assessment of Concussion, neuropsychological assessments, and the Balance Error Scoring System. Ongoing clinical symptoms, concussion history, and younger age identify those at risk for post-concussion impairments. Risk factors for recurrent concussion include history of multiple concussions, particularly within 10 days after initial concussion. Risk factors for chronic neurobehavioral impairment include concussion exposure and APOE e4 genotype. Data are insufficient to show that any intervention enhances recovery or diminishes long-term sequelae post-concussion.”

The bottom line? All concussions are different and each player suspected of having a concussion needs to beindividually evaluated with a combination of resources including neuropsychological assessment and medical evaluation. Concussions are serious injuries and when in doubt, keep them out!

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